Psychologist sues California prisons over anti-LGBT harassment

Housing unit at Vacaville

Prisons are not known as bastions of healing energy. One of the challenges faced by prison clinicians in the violent and hypermasculine culture of prison is how to uphold their professional ethics when they witness abuse of prisoners by staff. Psychologists may feel internally conflicted, but they rarely file formal complaints that might jeopardize their careers or even their personal safety.

So a lawsuit brought by a California psychologist against the Department of Corrections for alleged harassment of sexual minority prisoners is both rare and potentially groundbreaking.

Lori Jespersen, who identifies as “an openly genderqueer lesbian,” states that she was harassed and ostracized after she began blowing the whistle on rampant mistreatment of transgender and gay prisoners at the California Medical Facility at Vacaville.

Examples of prisoner abuse alleged in her lawsuit, filed this week in the U.S. District Court for the Eastern District of California, included an instance in which three prison employees “outed” one of Dr. Jespersen's transgender patients on Facebook, providing the prisoner's name and location, identifying her as a mental health patient, and referring to her as “he/she” and “that thing.”

In another alleged incident, a prison employee left a door unlocked while a gay prisoner of color was showering, enabling another prisoner who had been assaulting sexual minority prisoners to enter the shower and assault him. When Dr. Jespersen filed a report under the Prison Rape Elimination Act (PREA), she says it was never investigated. 

Dr. Jespersen alleges that due to her efforts to call attention to the abuse of LBGT prisoners, she was subjected to constant name-calling and threats of violence, including being locked alone on a housing unit with dangerous rapists. She stated the harassment caused her anxiety, depression, sleep disturbance and weight gain, and that she now “lives in constant fear of violence and harassment at work and at home.”

Transgender prisoner at Vacaville

Dr. Jespersen, 41, went to work for the California Department of Corrections and Rehabilitation (CDCR) in 2008, the same year she became licensed. The following year, she transferred to the Medical Facility at Vacaville, which has specialized programming for transgender prisoners.  

No safe haven?

If true, her allegations are especially disturbing in that Vacaville has long been regarded as a haven for transgender prisoners. In 1999, during the height of the AIDS epidemic, it became one of only two prisons in the country with specialized medical services for trans prisoners, the majority of whom were infected with HIV.

Dr. Jespersen’s attorney, Jennifer Orthwein, a former forensic psychologist whose practice focuses on gender and sexual orientation discrimination, said that the main goal of the lawsuit is to bring attention to the issue of systemic discrimination, in order to compel a cultural change.

“This case really has the potential to shine a spotlight on what is the key barrier to making progress to protecting vulnerable inmates in these facilities,” echoed Shannon Minter, the legal director of the National Center for Lesbian Rights, in an interview with public radio’s The California Report, “and that is this prison culture of silence and retaliation.”  

Trans prisoner at CDCR, UC Irvine study

Transgender prisoners are more than 13 times more likely to be sexually assaulted than the general prison population, according to a 2009 study by hate crimes scholar Valerie Jenness at UC Irvine’s Department of Criminology. About 59 percent of transgender prisoners in California reported being sexually assaulted, compared to less than 5 percent of other prisoners. 

Allegations of prisoner mistreatment are not new for California’s massive prison system, which has been under federal oversight for more than a decade due to chronic shortcomings in the treatment of mentally ill and low-functioning prisoners.

The lawsuit also comes at the same moment as a major power shift in the direction of the California Medical Facility. Under the state’s 2017-2018 budget, the intensive 24-hour inpatient psychiatric program at Vacaville and two other prisons has been shifted from the Department of State Hospitals to the Department of Corrections, which has been awarded an extra $254 million and nearly 2,000 new jobs to run them. The shift has caused consternation among mental health personnel, who worry about the quality of psychiatric care and the potential for increased suicides under CDCR management.

Prison psychologist awarded $1 million over racial bias

Although it is rare for prison psychologists to engage in whistle-blowing or file lawsuits, the last time such a case went to trial, the jury awarded the psychologist $945,480 in damages for racial discrimination, a judgment that was upheld unanimously on appeal.  

That case was especially disturbing, in that by all accounts Terralyn Renfro was a highly dedicated clinician who went above and beyond her formal duties in her desire to rehabilitate the men in the California prisons where she worked as a contract psychologist. Indeed, it was her very zeal that apparently cost her her career.

According to testimony at her trial, her supervisors did not approve of her attempts to facilitate prisoner self-help groups. They were especially upset that she had set up a self-help library, which became very popular with prisoners at Mule Creek State Prison in Ione.

The manner of Dr. Renfro's firing was humiliating. Without warning, a prison bureaucrat walked up to her one day and handed her a termination notice giving her 75 minutes to leave the prison or be physically ousted by guards. He stayed by her side and escorted her out the gates and to her car. A “DO NOT HIRE” note was placed in her file, so she was repeatedly rejected for jobs at other state prisons. No one ever explained who placed the note, or why.

The Third District appellate court upheld the jury’s nearly $1 million verdict against the prison system for racial discrimination in the firing. Dr. Renfro was the only African American psychologist at Mule Creek Prison at the time.

“Discrimination does not always present as in a scene from To Kill a Mockingbird or The Birth of a Nation,” the appellate court noted. “Even the most racially intolerant manager will often appreciate the need for circumspection, so smoking guns are rarely found.... [T]he jury drew a reasonable inference of discrimination from a pattern of deception, obfuscation, and mistreatment.”

But from the information in the record, the larger impetus for Dr. Renfro’s firing was her zealousness in prioritizing the interests of the prisoners in her care over those of the bureaucrats to whom she reported. The same behavior, perhaps, of which Dr. Jespersen may ultimately be deemed guilty.

* * * * *

The complaint in Jespersen vs. CDCR is online HERE.  The appellate opinion in Renfro vs. CDCR is HERE.

“Help! I am being held hostage in a reality show!”

The Suspicion System: How the social world shapes delusions

Not so long ago, any decent-sized psychiatric hospital had at least two or three Jesus Christs in residence, and plenty of other patients serving as conduits for the CIA or the KGB.

Nowadays, Jesus Christ is harder to find. You are far more likely to encounter reality TV stars: patients whose every move is choreographed by hidden directors, videotaped by hidden camera crews, and broadcast without consent to an audience of millions. “We see many, many young people who have had the sensation of being filmed,” a psychiatrist at a public clinic in London told the New Yorker. His estimate: One or two out of every 10 patients he sees. 

This so-called Truman Show Delusion is not so irrational in our modern surveillance state, where we (and our cars) are photographed and videotaped whenever we venture into the public space, microphones capable of recording our conversations and instantly beaming them to authorities are hidden in street lighting, and – as exposed by Edward Snowden – the NSA is intercepting vast swaths of our communications and storing them in a massive, top-secret vault in the Utah desert. Soon, our homes will afford no privacy; the CIA is cheering the advent of the “smart home” as a bonanza for clandestine eavesdropping. If you scoff at the notion that They are watching you, revisit the chilling scene in the Bourne Ultimatum (2007) in which Matt Damon tries to avoid the cameras in London’s Waterloo Station.   

The solipsist premise of Peter Weir’s 1998 Truman Show, starring Jim Carrey as an insurance adjuster who realizes that his entire life is actually a TV show, was not original. The psychiatric patient in Robert Heinlein’s 1941 short story, “They—,” was convinced that he was an actor on a stage; the troubled protagonist of Philip K. Dick’s 1959 novel, Time Out of Joint, also starred in his own self-constructed reality. But in an innocent era before the entrenchment of the panoptical gaze or reality TV – in which any random person, it seems, can wake up to find him- or herself an instant social media celebrity – these stories were fantastical, and thus incapable of producing mass contagion. 

But the cultural environment influences more than just the superficial content of persecutory or grandiose delusions. Far more profoundly, it impacts who will catch psychosis, and why. This blog’s readers may know that early use of cannabis significantly increases the risk of psychosis, as does experiencing childhood adversity such as severe abuse or parental loss. You may also be aware that merely growing up in a city puts one at heightened risk of mental breakdown; there is a near-linear correlation between population density and psychosis. But consider these further research findings:

• The greater a nation’s income inequality, the higher its per capita rate of psychosis. 

• Immigration is a major risk factor for psychosis – and not just for the immigrants themselves, but for their first-generation offspring. Nor is this risk equally distributed: It is highest for darker-skinned people relocating to whiter countries, especially if they settle outside of ethnic enclaves.

The burden of social defeat

In Suspicious Minds: How Culture Shapes Madness, psychiatrist Joel Gold and his philosopher brother Ian identify social fragmentation as the construct tying these seemingly disparate strands together. More precisely, the experience of social defeat, in which a person who is persistently demeaned, humiliated, or subordinated ultimately comes to see himself as a second-class citizen.

I have long found delusional beliefs fascinating. In particular, I enjoy talking with delusional people, and trying to understand the meaning of their beliefs. In this, I’ve gained a lot from the theories of luminaries in the field such as Brendan Maher, Richard Bentall and John Read. But Suspicious Minds is brilliant in pulling together all of the extant research to create a single unified theory, one that foregrounds and humanizes the delusional person’s experience.

The theory developed out of Joel Gold’s experiences as attending psychiatrist at New York City’s notorious Bellevue Hospital. After treating several patients with Truman Show delusions, he – in partnership with his brother Ian, a philosophy professor at McGill University in Canada – published a 2012 article on the phenomenon in Cognitive Neuropsychiatry. That, in turn, generated a deluge of emails from people all around the world who were relieved to realize they were not the only one who thought their lives were being secretly filmed and broadcast to the masses.

The Gold brothers’ theory of delusions as a social phenomenon goes against the grain in this era of pharmaceutical industry domination and biological reductionism, especially here in the United States, where the social context of mental illness has been systematically suppressed in favor of simplistic theories of genetic or chemical imbalances.

But things have a way of circling back around. Almost 50 years ago, against the backdrop of the assassination of Martin Luther King and the ensuing inner-city rebellions, African American psychiatrists William Grier and Price Cobbs dissected the psychic burden of prejudice. To survive, they wrote in their influential 1968 book Black Rage, oppressed people must maintain a delicate balancing act of being ever-vigilant and suspicious, yet without succumbing to frank paranoia:

“[S]urvival in America depends in large measure on the development of a ‘healthy’ cultural paranoia. [The black man] must maintain a high degree of suspicion toward the motives of every white man and at the same time never allow this suspicion to impair his grasp of reality. It is a demanding requirement and not everyone can manage it with grace…. Of all the varieties of functional psychosis, those that include paranoid symptoms are by far the most prevalent among black people.”

The panoptical gaze in The Bourne Ultimatum

Suspicion, then, is necessary and adaptive, especially for those most vulnerable to exploitation. But when chronic stressors overwhelm the brain’s capacity to cope, delusions are kindled. This is the essence of the Golds’ theory of delusions as the product of an overtaxed “Suspicion System.”

Drawing on recent research in neuroscience and evolutionary psychiatry, the Golds locate the Suspicion System in the amygdala – evolved to anticipate threat by interpreting ambiguous signs of potential social danger – and connected brain regions. Delusions take hold, they posit, with a breakdown in communication between this early-warning Suspicion System and the more rational, slower-thinking (“System 2” in Daniel Kahneman’s formulation) cognitive network that should be dampening the amygdala’s over-enthusiasm.

A solid theory should not only be logical, elegant, and empirically supportable, but should also explain diverse manifestations of a phenomenon. The Golds’ theory explains not just persecutory delusions, but each of the other 11 major delusional themes (e.g., grandiose, religious, erotomanic) as well. For example, grandiosity  – which we see in the Truman Delusion  – can be interpreted as a way of deflecting threat, much like a puffer fish blows itself up or a cat arches it back when faced with danger:

“Flexing your social muscles makes you less vulnerable to exploitation by others, and putting your high status front and center in a potential exploiter’s mind might make them think twice about victimizing you…. Grandiosity is thus a symptom of a Suspicion System on overdrive, a caricature of the normal adaptive strategies we employ every day…. Paranoia and grandiosity … are functionally connected: paranoia is a broken form of threat detection, and grandiosity is a broken threat response.”

With ever-growing income disparity and economic stress, social network disintegration, loss of privacy,  and social media's increasingly panoptical reach, we may expect more and more alienated people with trouble psyches to succumb to Truman Show delusions. Let us hope that, in treating them, we do not lose sight of their humanity, for they really are  not so different from us. As the Golds put it, “mental illness is just a frayed, weakened version of mental health.”

Indeed, if we listen, these frantic souls may even have something to teach.

How locking kids in solitary confinement became normal

I remember the first time I ever saw a child locked up in a men's prison. I was walking down the corridor of a maximum-security prison, visiting a prisoner who had been transferred there from the prison where I was working at the time. (That's a sad story for another day.)

Suddenly, I saw the face of a boy, staring out at me bleakly from a cell window. The incongruity of the boy's presence in a men's prison made me do a double-take. I stared back for a long moment into his haunted eyes. When I asked about him later, I was told that, as the only minor at the prison, he had to be locked down 24/7 for his own protection.

I remember thinking at the time that even if a minor was tried and sentenced as an adult, there should be a provision to keep him in a juvenile lockup until he turned 18, so that he would be with others his age, have access to educational programming, and not be such a target for victimization.

Fast forward to 2014, and such a sight is no longer unusual. Thousands of minors across the United States are locked up in adult prisons and county jails, and many of them are kept in solitary. Manhattan's Rikers Island, the second-largest jail in the United States, houses hundreds of minors, and roughly one-fourth are in punitive segregation at any given moment. What makes this especially appalling is that most of these minors are pretrial detainees, not yet convicted of any crime. 

Spotlight on Rikers island

Ismael "Izzy" Nazario has recently become the public face of the problem. Now 25 and a case manager for juveniles coming out of Rikers, he estimates that as a juvenile he spent about 300 days altogether in "The Box," a dreaded 6x8 cage; his longest single stay was four months. After a while, he said in a video (which has since been removed from YouTube), you start to go crazy. You pace back and forth and talk to yourself; your eyes start playing tricks on you. "Your mind becomes your own worst enemy."

Ismael "Izzy" Nazario

Nazario's experience is not unusual. According to a state report, teens in solitary at Rikers are more likely than other detained juveniles to try to harm themselves. Nationwide, more than half of detained juveniles who commit suicide do so while locked in solitary confinement.

This is not surprising. As noted by developmental psychiatrist Bruce Perry in an interview with the Center for Investigative Reporting, solitary confinement is bad for anyone -- but it is especially bad for children. And as we forensic professionals know, incarcerated children are not just any children; they are children who have already experienced major losses and traumas in their young lives. Traumas that make them more vulnerable to the deleterious effects of isolation:

"They end up getting these very intense doses of dissociative experience, and they get it in an unpredictable way. They’ll get three days in isolation. Then they’ll come back on the unit and get two days in isolation. They’ll come back out and then get one day. They end up with a pattern of activating this dissociative coping mechanism. The result is that when they’re confronted with a stressor later on, they will have this extreme disengagement where they’ll be kind of robotic, overly compliant, but they’re not really present. I’ve seen that a lot with these kids. They’ll come out, and they’re little zombies. The interpretation by the staff is that they’ve been pacified. 'We’ve broken him.' But basically what you’ve done is you’ve traumatized this person in a way that if this kid was in somebody’s home, you would charge that person with child abuse."

Being a feifdom, Rikers has steadfastly refused to allow journalistic access. But  New York City Councilman Daniel Dromm, one of the few outsiders to witness conditions in The Box, pulled no punches in labeling what he saw "torture." Dromm is campaigning for more transparency. At minimum, he wants Rikers administrators to report the number of minors locked in punitive segregation, their ages, and their infractions. “We need to unveil the secrecy," he said.

Rikers Island in the 1930s, Lucien Aigner

The international community agrees with his categorization. The United Nation classifies solitary confinement as a form of torture, prohibited for children under international law.

The correctional officers' union disagrees with this prohibition. A spokesman said outsiders just don't understand the need for force -- including punitive segregation -- to keep testosterone-fueled young men in line in "the belly of the beast."

I found that turn of phrase more than a little intriguing, coming from a correctional officer. Although the origins and meaning of the phrase are a bit murky, since the publication of Jack Abbott's prison memoir by that the title in 1981, in reference to the American prison system it is generally used to invoke a brutal and unjust system, which one opposes even from within.

But the phrase is apropros, because beastly the system is.It takes already marginalized youth and bestows the ultimate lesson in disempowerment and dehumanization. As Bruce Perry puts it, it announces to disenfranchised minors that, as a society, "we don’t care for you."

That's a harsh message, and one that these young people will have fully internalized by the time they are set back loose into society, broken or vengeful as the case may be.

The silver lining is that Rikers Island conditions are gaining traction as a symbol of the plight of children in adult correctional institutions nationwide. PBS Newshour recently highlighted the issue. And the Center for Investigative Reporting features a series of reports on the online media platform Medium.

Long-burning embers of 1990s superpredator wildfire 

But how did we ever get to the point that children are being tried and incarcerated as adults in the first place, not to mention locked in solitary confinement in adult institutions?

Not all of us are even old enough to keenly recall the 1990s hysteria surrounding juvenile "superpredators," marauding Black and Brown youth who were predicted to engulf society within a few short years if nothing was done to stop them.

This week, the New York Times produced a superb "retro report" video, documenting the history of the superpredator panic. Archived news clips bring us back to the moment when it all began, with incendiary predictions of two academics -- prominent political scientist John J. Dilulio Jr. and criminologist James Fox.

It was Dilulio who coined the term "superpredator," which invokes an animal menace in hordes of "Godless" young Black males, "a ticking time bomb" waiting to erupt; Fox added his own inflammatory rhetoric about the “bloodbath” that was just around the corner.

"And like a match to a flame, the word caught on.... Life in the 1990s [became] dominated by a sense that youth violence was out of control. The future looked bleak. To explain why, one word said it all – superpredators.... A growing wave of kids who were going to ravage the country…. The prediction was terrifying, and lawmakers cracked down on juvenile offenders."

Conservative politicians seized the moment. Aided by fears over changing racial demographics, they were able to pass harsh laws in nearly every U.S. state to allow for juveniles to be tried as adults and to exponentially increase their punishments.

Ironically, at the very moment these laws were being enacted, juvenile crime rates began their unprecedented plummet, the exact opposite of what Dilulio and Fox had predicted. The two men now admit that they were flat-out wrong. In 2012, they both went so far as to sign an amicus brief arguing against life imprisonment for children convicted of murder.

But it was too late. The punitive social climate they had ignited was like a wildfire that burned far out of control. And it's still burning across the United States, from Rikers Island to Los Angeles County and everywhere in between, consuming untold thousands of teenagers from the most vulnerable classes of society.

Hat tip: Kathleen

* * * * *

For those interested in the topic of juveniles sentenced as adults, I recommend the award-winning film Juvies.

(c) Copyright Karen Franklin 2014 - All rights reserved

Research review II: Sexual predator controversies

Following up on last week’s research review, here are some new articles from the ever-controversial practice niche of sexually violent predator cases:

Facts? Who cares about the facts?!

Once a jury is empaneled to decide whether someone with a prior sex offense conviction is so dangerous to the public that he should be civilly detained, the verdict is a foregone conclusion. Dangerousness is presumed based on the prior conviction, rather than having to be proven.

Researchers Nicholas Scurich and Daniel Krauss confirmed this by giving jury-eligible citizens varying degrees of information in a Sexually Violent Predator (SVP) case and asking them to vote. Some mock jurors were told only that the person had a prior conviction for a sex offense. Others were also given information that the person had a mental abnormality that made him likely to engage in future acts of sexual aggression.

It mattered not a whit. The mock jurors voted to civilly commit at the same rate, whether or not they had heard evidence of current dangerousness.

“The mere fact that a respondent had been referred for an SVP proceeding was sufficient for a majority of participants to authorize commitment,’ the researchers found. “These findings raise concerns about whether the constitutionally required due process occurs in SVP commitment proceedings.”

No surprise, really. In this practice niche more than others, fear and hype often overshadow reason. Sex offenders are not the most appealing human beings, and no one wants to shoulder the responsibility of voting to release someone who could go out and rape or molest again.

The study is:

The presumption of dangerousness in sexually violent predator commitment proceedings, Nicholas Scurich and Daniel A. Krauss, Law, Probability and Risk. A copy may be requested from the first author (HERE).

---

Sexual disorder diagnoses not reliable

Meanwhile, even when jurors do hear evidence of mental abnormality, it is not especially accurate.

Examining the diagnoses given to 375 sex offenders referred for civil commitment in New Jersey, researchers found “questionable” diagnostic reliability to be a widespread problem across the range of clinicians.

Pedophilia was the only diagnosis in which two evaluators were likely to agree at a level above chance. The rates of agreement were far worse for other disorders that are typically rendered in SVP cases, including “Paraphilia Not Otherwise Specified,” Sexual Sadism, Antisocial Personality Disorder and Exhibitionism. In fact, among the six cases in which Exhibitionism was diagnosed, there was not a single case in which both clinicians agreed.

The study, by Anthony Perillo of John Jay College and colleagues, adds to a burgeoning body of literature (some of which I’ve previously reported on) suggesting that psychiatric diagnoses in SVP evaluations are often dubious and not to be trusted.

The article is:

Examining the scope of questionable diagnostic reliability in Sexually Violent Predator(SVP) evaluations, Anthony D. Perillo, Ashley H. Spada, Cynthia Calkins and Elizabeth L. Jeglic, International Journal of Law and Psychiatry. A copy may be requested from the first author (HERE).

---

Race bias in actuarial risk prediction

Okay, so the diagnoses aren’t reliable. But we’ve still got another tool of science up our sleeves -- actuarial risk assessment.

Not so fast.

As I’ve previously reported, the predictive accuracy of actuarial risk assessment tools is pretty wimpy. And now, researchers from Sam Houston State University are finding that the most widely used actuarial tool, the Static-99, doesn’t work at all with Latino offenders.

The findings are based on research with a large sample of about 2,000 sex offenders, almost 600 of whom were Latino.

“Findings have implications for fairness in testing and highlight the need for continuedresearch regarding the potentially moderating role of offender race/ethnicity in risk research,” note researchers Jorge Varela and colleagues.

The study is:

Do the Static-99 and Static-99R Perform Similarly for White, Black, and Latino Sexual Offenders? Jorge G. Varela , Marcus T. Boccaccini, Daniel C. Murrie, Jennifer D. Caperton and Ernie Gonzalez Jr. International Journal of Forensic Mental Health. To request a copy from the first author, click HERE.

---

How to lie with statistics: “The Area Under the Curve”

Listen to any defender of actuarial risk prediction for a few minutes, and you will likely hear "Receiver Operating Characteristics” and “The Area Under the Curve” touted as indicators of statistical accuracy.

But in a new study in the Journal of Threat Assessment, two European scholars argue that these arguments are “fundamentally misleading.” Using the Risk Matrix 2000 instrument -- widely deployed in the United Kingdom -- as an exemplar, they found that a prediction of reoffense for an offender who scored in the “Very High Risk” range will be wrong an astounding 93 percent of the time.

“The numbers necessary to detain in order to prevent one instance of recidivism are large,” write David Cooke and Christine Michie. “On further reflection, from a statistical rather than a psychological perspective, should we be surprised? It has long been recognized that low-frequency events are hard to predict.”

The authors argue that the weak performance of actuarials is being systematically camouflaged by “statistical rituals” that are confusing and non-transparent, raising fundamental questions of fairness in legal decision-making.

The article is:

The Generalizability of the Risk Matrix 2000: On Model Shrinkage and the Misinterpretation of the Area Under the Curve. David Cooke and Christine Michie. Journal of Threat Assessment and Management. To request a copy from the first author, click HERE.

---

Counterpoint

Not everyone agrees with Cooke and Michie’s analysis. One detractor is Douglas Mossman, of the Department of Psychiatry at the University of Cincinnati College of Medicine. Using a fictional scenario, he attempts to illustrate how "group data have an obvious application to individual decisions.” His paper goes on to argue that “misinterpretations of mathematical concepts and misunderstanding of the aims of risk assessment have led to mistakes about the applicability of group data to individual instances.”

The paper is:

From Group Data to Useful Probabilities: The Relevance of Actuarial Risk Assessment in Individual Instances. (Unpublished.) Douglas Mossman. Paper available online (HERE).

---

Who is minding the store?

If nothing else, the above research snippets demonstrate the high level of controversy and complexity in the implementation of Sexually Violent Predator laws. If psychologists -- who must master psychometrics and statistics in order to earn our PhD’s -- have a hard time with these concepts, imagine how difficult it is for attorneys. With people’s lives at stake, do they have the knowledge base necessary to avoid being hoodwinked, and to educate jurors and judges?

In a new paper, prolific legal scholars Heather Cucolo and Michael L. Perlin of the New York School of Law argue that more stringent standards for representation are necessary for effective assistance of counsel in SVP cases.

They propose that counsel should be required to “demonstrate a familiarity with the psychometric tests regularly employed at such hearings, and with relevant expert witnesses who could assist in the representation of the client.” Furthermore, they argue for a pool of court-appointed experts who could be appointed at no cost, similar to those provided in insanity cases.

“There is no question that the population in question is the most despised group of individuals in the nation. Society’s general revulsion towards this population is shared by judges, jurors and lawyers. Although the bar pays lip service to the bromide that counsel is available for all, no matter how unpopular the cause, the reality is that there are few volunteers for the job of representing these individuals, and that the public's enmity has a chilling effect on the vigorous of representation in this area.”

The paper is:

'Far from the Turbulent Space': Considering the Adequacy of Counsel in the Representation of Individuals Accused of Being Sexually Violent Predators. Heather Cucolo and Michael L. Perlin. It is available online HERE.